How do I differentiate between Autistic rigidity and anorexia nervosa?

How do I differentiate between Autistic rigidity and anorexia nervosa?

I am not anorexic. I never was anorexic. I am in recovery from anorexia, which is a parasitic, all-consuming mental condition that sucked the joy out of every aspect of my life like a Dementor*. But even though anorexia controlled most of my life, I never wanted it to be my identity; I didn’t want to be “anorexic.”
Anorexia is an illness I have, which will hopefully pass. A person who has cancer is not cancerous; someone with COVID-19 is not a Covidite. I have anorexia, but it is not who I am.

High cost of valuing thinness

During my first hospital admission, I learned some people want to “learn to be anorexic,” as though there is a secret to having the willpower to diet and exercise without giving in to their body’s shameful survival needs. Can we take a second to take that in? Western society values thinness so highly that people want to learn how to consistently deprive their bodies of essential sustenance.
Rather than learning to resist buying the latest iPhone or another pair of designer jeans, people focus on eliminating food — something that keeps them alive. I’m blaming the media’s rhetoric – fake news – for making people believe that “anorexics” effortlessly starve themselves, enjoy compulsively over-exercising every day and legitimately don’t want dessert because “nothing tastes as good as skinny feels.”

Cost of equating body size with success

My experience is that skinny feels great, but only because it is physical proof of my hard work and willpower. The pride I felt from this “achievement” did not make up for the constant exhaustion, deep self-hatred, failing organs, incessant internal debate, guilt, rigidity, and the list goes on.
The secret I wanted to learn was how to be thin without trying. I dreamed of being able to rest easy in the knowledge that I was socially acceptable without needing to constantly track my calorie intake and expenditure. Such freedom!
Logically, I know a person’s body size and shape do not determine their value as a person. However, I also know most people in Western society value and reward thinness. I know I will receive better treatment and greater respect if I am slim than if I am in a bigger body.
As an introverted, self-conscious, observant teenager, I learnt that a slim, pretty person who is a bit socially awkward will usually be labelled “quirky” or “an individual.” In contrast, an unattractive person with a bigger body who makes the same social faux pas will be cast out as a “dork,” “weirdo,” or “loser.”

Cost of the weird dork category at school

It has nothing to do with vanity; it’s called survival. At school, I knew I was in the weird dork category; I often seemed to say the wrong thing in social situations – though I could never quite work out why what I said was wrong, while someone else making a very similar joke was funny – and I felt I was irreparably different from most other people at my very core.
I didn’t want to spend my life on the outside, observing others having fun while never being invited in or fully accepted. I was already thin, but maybe if I was even thinner, without any fat at all – all fat is bad, right? – that would outweigh my awkwardness. Perhaps then I would be accepted and would learn from my new friends how to be normal and funny.

The relief of learning I am Autistic

Twenty years later, I have learnt that obscure feeling of not quite fitting in and having a different – different, not wrong – communication style is because I am Autistic. I don’t have autism; I am Autistic, with a capital “A”. It is in my genes, and I’m proud of it. It’s a relief to understand why I felt like an oddball for so long.
There’s a whole community of people just like me, with whom I communicate fluently without over-thinking everything I say, and I fully embrace the positives of being Autistic. A huge contributor towards my low self-esteem was my failure to be normal, no matter how hard I tried. Knowing the real reason for my inherent oddness has been an immeasurable help in my recovery.
However, a lot of my Autistic traits fuel the anorexia nervosa (there is a genetic link between Autism and anorexia, and approximately one-third of people with anorexia are also Autistic), which is part of the reason recovery is usually a longer journey for Autistic people. (The other main reason is a dearth of research into effective and non-traumatic treatment methods for Autistic people).

Autistic traits ‘fertilise the weed of anorexia nervosa’

For most people, starvation causes rigid thinking and obsessive behaviours around food (see Minnesota Project). For those of us unfortunate enough to possess the collection of genes necessary to develop anorexia nervosa, starvation can also lead to compulsive exercise, obsessive food rituals and extreme anxiety if anything of anyone prevents us from carrying out these behaviours. As rigidity, Obsessive Compulsive Disorder (OCD) and anxiety are common Autistic traits; they fertilise the weed of anorexia nervosa.
As someone in recovery, how do I differentiate between Autistic rigidity and anorexia nervosa?
— Do I want to eat my meals at the same time every day because I’m Autistic or because sticking to my schedule means I eat about the same amount each day and, therefore, probably won’t put on weight?
— Do I eat the same food at every meal because I enjoy it and Autistic me feels safe in the predictability (Autistic people often eat the same meals every day because the monotony helps us feel safe and comfortable, and it reduces the load of executive functioning) or because eating the same number of calories every day keeps me at this weight?
— Do I feel that I’ve wasted a meal I didn’t enjoy because I’ve missed out on the stimulation of delicious tastes and textures (while some Autistic people can only handle bland, soft food, some of us crave strong flavours and stimulating textures), or is that thought remnants of my old, disordered thinking patterns, that banned me from eating anything additional to my strict food plan?

Knowledge helps to manage the challenges

The only thing I can say for sure is that the answers to these questions will be different for everyone. I find it helpful to ask myself if I would follow these rules if doing so did not affect my weight. Unfortunately, the answer usually reveals that my compulsion is caused by Autism and lingering anorexia nervosa. However, at least this feedback can help me decide if and how I will challenge the thoughts and who I can approach for help.

* Unfortunately, by the time I came up with this analogy, I couldn’t remember any truly happy memories strong enough to fuel a Patronus.